Provider Demographics
NPI:1710920947
Name:GOPALAKRISHNAN, RAJALAKSHMI T (MD)
Entity Type:Individual
Prefix:
First Name:RAJALAKSHMI
Middle Name:T
Last Name:GOPALAKRISHNAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:11965 MOORLAND MANOR CT
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-5359
Mailing Address - Country:US
Mailing Address - Phone:314-872-3508
Mailing Address - Fax:
Practice Address - Street 1:915 N GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63106-1621
Practice Address - Country:US
Practice Address - Phone:314-652-4100
Practice Address - Fax:314-289-7012
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2021-12-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2004026419207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology